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KMID : 0390219990100010061
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Journal of Clinical Otolaryngology, Head and Neck Surgery
1999 Volume.10 No. 1 p.61 ~ p.65
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Effects of Hypertonic Saline on Nasal Mucociliary Clearance in Normal Adults Using Radioisotope Tracer
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Abstract
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Background and Objectives : Nasal irrigation has been used usually in the treatment of
patients with acute and chronic sinusitis and has also been utilized in the postoperative
care of functional endoscopic sinus surgery patients. Nasal irrigation aids in the
clearance of secretion, infective debris and intranasal crust which may lead to adhesion.
Solutions used for nasal irrigation should not allow any impairment on the mucociliary
system which contributes to the defense mechanism of the respiratory tract. For many
decades, rhinologists have used normal saline as an ideal solution for mucociliary
system. Recently, there are some reports that nasal irrigation with hypertonic(3%) saline
is more effective on sinusitis and postoperative care of sinus surgery than irrigation
with normal saline. But those were based on data using saccharine, which is a soluble
tracer. And there is no report using insoluble tracer which reflects transport ability of
gel layer of the mucous blanket. Therefore we performed this test in order to evaluate
the effect of hypertonic saline on nasal mucociliary clearance in normal adults.
Materials and Method : We studied 20 normal adults who did not have nasal diseases,
aged from 17 to 24 years old, using human albumin tagged with radioisotope (Tc
99m). Nasal glow test was done with Glatzel mirror and open side was
chosen. Control measurement was done before spray of normal saline and hypertonic
(3%) saline. Also, the effects of normal saline and hypertonic saline on mucociliary
clearance were measured after spray. Results : After spray of normal saline, mucociliary
clearance increased to 4.96±2.33mm/min, whereas in the control group was 4.60±1.85mm/min.
However, there were no statistical differences between the normal saline
group and the control group(p=0.5288). But mucociliary clearance of hypertonic saline
group increased to 5.96±2.50mm/min, whereas in the control group was 4.92±2.34mm/min
and there were significant differences between hypertonic saline group and
the control group(p=0.0142). Conclusion : The results of this study suggest that
hypertonic (3%) saline irrigation has the effect of improving nasal mucociliary clearance.
Also the results suggest that hypertonic saline affects the gel layer. Further rheologic
studies should be made in order to know the mechanism of effect of hypertonic saline
on mucociliary clearance.
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